Infected giant lymphangioma circumscriptum treated with a combination therapy.

Lymphangioma circumscriptum is an uncommon benign disorder of skin and subcutaneous tissues characterized by dilated lymphatic channels. It is an uncommon vascular tumor and it rarely becomes infected. We report a 20-year-old man who had an infected giant tumor in his left thigh. After an extensive resection and radiofrequency energy therapy, he recovered well with an acceptable cosmetic result. We followed up the patient for 2 years without any recurrence.

A clinical evaluation of lymphangioma of the large intestine: a case presentation of lymphangioma of the descending colon and a review of 279 Japanese cases.

With the development and widespread use of colonoscopy, lymphangioma of the large intestine has recently been reported frequently. This paper presents some findings from a review of 279 cases of this disease in Japan, including a typical case that we encountered. A 69-year-old female was diagnosed as having lymphangioma of the descending colon based on the findings of a barium enema and a colonoscopy, and the lesion was successfully removed by an endoscopic resection. In the published reports, the etiology of this disease is not clear yet but the age at onset range shows a tendency toward a higher incidence in comparatively older patients and the male-to-female ratio indicates a higher incidence in males. If there is no complication, endoscopic treatment seems to be the preferable procedure for this disease.

Lymphangioma of the colon: a case report and review of the Japanese literature.

Intraabdominal lymphangiomas are rare, although these lesions can occur in the mesentery, omentum, retroperitoneum, or gastrointestinal tract wall. Here we report a case of lymphangioma of the transverse colon and review the other cases reported in the Japanese literature. Our patient presented with lower abdominal pain and barium enema revealed a filling defect in the transverse colon. Colonoscopy disclosed a submucosal tumor, which changed shape with alteration the patient's position and showed the cushion sign. This lesion was covered with normal-looking mucosa. A correct diagnosis was made from these findings. Knowledge of these endoscopic features may help physicians to provide appropriate diagnosis and treatment of colonic lymphangioma.

Linfohemangioma: diagnóstico ultrasonográfico antenatal: alternativas de manejo postnatal / Lymphangioma: prenatal ultrasonographic diagnosis: postnatal care alternatives

Los linfohemangiomas son tumores benignos del sistema linfático, caracterizados por vasos linfáticos anastomóticos y espacios quísticos de tamaño variado pero generalmente menores de 0,5 cm de diámetro. Característicamente son infiltrativos por extensión local. Su tamaño está relacionado con el grado de destrucción linfática. Estos tumores muestran predilección por la lengua, cuello, tórax, extremidades y peritoneo. Aparecen precozmente en la vida, algunos de ellos se diagnostican mediante la ultrasonografía prenatal. Este examen en manos de profesionales experimentados puede definir un diagnóstico temprano mediante la ultrasonografía transvaginal. Los diagnósticos ultrasonográficos de malformaciones linfáticas pueden hacerse tan precoces como a las 12 a 15 semanas, especialmente en lo que concierne al higroma quístico. El origen embriológico de estas lesiones es dudoso y no se sabe si son malformaciones, neoplasias benignas o hemartomas. Pueden aparecer como masas uniloculadas o quísticas de pared delgada y a menudo transparentes. Son más firmes que los higromas y están formadas por estroma conectivo denso, más tejido linfático. La regresión es rara y la infección es muy seria, pudiendo conducir a una sepsis. La clasificación tradicional divide los linfangiomas en cuatro grupos: 1) linfangioma capilar, 2) linfangioma cavernoso, 3) linfangioma quístico, 4) linfohemangioma. Si se asocian cambios venosos y dilatación capilar y ocasionalmente se interpone tejido linfático que se vasculariza extensivamente, se habla de linfohemangioma. Este tipo es extremadamente raro y se observa casi exclusivamente en el paciente adulto

[Fibrin adhesive: a new therapeutic alternative in the treatment of cystic lymphangioma]. / Adhesivo de fibrina: una nueva alternativa terapéutica en el tratamiento del linfangioma quístico.

We present three cases of cystic lymphangioma of the neck, treated with a new therapeutic method which consists of an injection of fibrin adhesive into the lesion following aspiration of the liquid contents of the lymphangioma. Two of the cases had been treated surgically and were faced with the recurrence of the tumor, the aforesaid treatment was applied. In the third case, it was the only therapy applied. We believe that the results obtained were excellent in all three cases.

Linfangioma quístico retroperitoneal gigante: informe de un caso / Giant retroperitoneal cystic linfangioma: one case report

Se informa un caso de linfangioma quístico gigante retroperitoneal, diagnosticado y tratado en el Hospital Juárez de México; masculino de 38 años de edad, con manifestación clínica de ascitis y masa palpable en ambos cuadrantes derechos del abdomen. Datos de laboratorio de anemia normocítica normocrómica, hipoproteinemia hipocolesterolemia, los estudios radiológicos convencionales: colon por enema, serie gastroduodenal y urografía excretora, demuestran desplazamiento de estos órganos por masa tumoral retroperitoneal del lado derecho. En la laparotomía se encuentra tumor retroperitoneal multiquístico de 40 x 30 x 14 cm, se extirpa en su totalidad; el diagnóstico histopatológico es de linfangioma gigante quístico retroperitoneal. Durante 5 años de seguimiento cursa asintomático y sin recidiva del tumor. En conclusión los LQR son raros, en su mayoría asintomáticos; los métodos radiológicos convencionales ayudan a localizar el tumor en el retroperitoneo, pero no así su extirpe linfática. En la actualidad se diagnostican preoperatoriamente con el empleo del ultrasonido, linfografía, pero principalmente con el uso combinado de la TAC y aspiración percutánea con aguja fina. Su tratamiento es la extirpación total.

Fibrin glue for the treatment of persistent lymphatic drainage.

A 7-year-old girl underwent resection of an abdominal wall lymphangiomatous tumor. Postoperative serous drainage, up to 300 mL per day, developed despite application of external pressure to the wound. Thirty-three days after the initial procedure, fibrin glue was applied to the draining tract. Concentrated fibrinogen was prepared from one unit of blood donated by the patient's mother. Ten milliliters fibrinogen and 10 mL thrombin (1,000 U/mL) were injected simultaneously through the wound drain as it was slowly removed, and pressure was reapplied for 48 hours. No further drainage occurred, and at 2- and 14-week follow-up examinations the wound had healed normally without reaccumulation of fluid. Fibrin glue successfully sealed this persistently draining abdominal wall tract. It is a painless, safe, and effective biologic sealant, and when prepared from homologous plasma it carries a low risk of virus transmission.

Treatment of cystic hygroma and lymphangioma with the use of bleomycin fat emulsion.

Of the several types of treatment for cystic hygromas and lymphangiomas, surgical excision has been the preferred treatment. However, there is a high recurrence rate because lymphangiomas tend to infiltrate the surrounding tissues. Bleomycin in a microsphere-in-oil (S/O) emulsion was used in this study as a sclerosing agent for lymphangiomas. Experimental studies using domestic rabbits showed that the bleomycin emulsion caused more marked fibrotic changes at the injection site than other formulations, such as a blank emulsion and bleomycin solution. In clinical trials, 27 of 33 patients received bleomycin S/O emulsion injected directly into the tumors with satisfactory results. Histologic pictures of the clinically resected specimens confirmed the findings of the experimental studies. Comparative studies of treatments between bleomycin S/O emulsion and surgery indicated that injection therapy of bleomycin S/O emulsion would be more beneficial than surgical excisions.

Laser photocoagulation of vascular malformations of the tongue.

Vascular malformations of the tongue (hemangiomas, lymphangiomas, AV fistulae, etc.) compromise a significant portion of head and neck angiodysplastic lesions. Complications requiring treatment include bleeding, pain, and difficulties related to increased tongue volume. Treatment modalities have included embolization, excision, cryotherapy, sclerosis, radiation, and chemotherapy. The more aggressive therapies often result in major functional disability to loss of lingual tissue. A series of nine patients has been treated for one or more of the complications of lingual vascular malformations with either argon of Nd:YAG laser photocoagulation. The therapeutic objective was provision of symptomatic relief with conservation of functioning lingual tissue. Results have varied from good to excellent with markedly decreased bleeding frequency as well as reduction in lesion size. No serious complications, such as bleeding or invasive infection, have been noted. Laser phototherapy is beneficial in the palliation of selected benign lingual vascular malformations.

Linfangioma quístico retroperitoneal: presentación de un caso y revisión de la literatura / Retroperitoneal cystic lymphangioma: presentation of a case and review of literature

Se presenta un paciente con un linfangioma quístico retroperitoneal, entidad muy poco frecuente. Se exponen el estudio clínico y los exámenes complementarios realizados, los que incluyeron urograma descendente, nefrotomograma, arteriografía, estómago y duodeno, colon por enema y laparoscopia. Se describe la técnica quirúrgica empleada y el resultado anatomopatológico de la pieza extraída. Se realiza una revisión de la bibliografía internacional y se exponen los criterios más importantes (AU)

Lymphangioma of the transverse colon treated by transendoscopic polypectomy: report of a case and review of literature.

This report concerns a 73-year-old man complaining of intermittent, dull, umbilical pain on one month's duration. Barium-enema examination and endoscopy revealed a hemispheric cystic tumor at the midportion of the transverse colon, and the presumptive diagnosis was cystic submucosal tumor of the colon. Transendoscopic polypectomy was performed and the bulk of the lesion was locally excised from the colonic mucosa. Histologic examination revealed cavernous lymphangioma originating from the submucosa.